Article

La maladie de Kienbock au stade IV - Chirurgie
Abstract : Kienbock disease is an aseptic osteonecrosis of the lunate, which gradually leads
to total carpal collapse. Lichtman's classification relates radiographic evidence
of wrist damage to four different stages and supports surgical decision-making.
This study pertains to six patients (2 males and 4 females) affected by stage IV
Kienbock's disease who underwent proximal row carpectomy and received an RCPI implant. The clinical outcomes consisted of wrist range of motion (ROM), pain on
a VAS scale (0-10), the DASH score and the patient's level of satisfaction. The
mean follow-up was 27.6 months (16-36). Pain relief and improvements in wrist
flexion - extension ROM, radial - ulnar deviation and strength were achieved in
every patient. There were no cases of implant failure or dislocation. Considering
the good results obtained,
we believe that proximal row carpectomy associated
with the use of a pyrocarbon RCPI implant is a valid surgical technique for the
treatment of stage IV Kienbock's disease. It is a good alternative to carpal
fusion, which leads to wrist immobility, and to total wrist joint replacement,
which has a high incidence of dislocation and fracture.
CI - Copyright (c) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS